The influence of training outcome and competency on effective utilization of malaria microscopy result amongst health professionals in South Eastern Nigeria

Malaria diagnosis in Nigeria mostly relied on clinical manifestations until 2011, when the government issued a policy requiring parasitological confirmation of all suspected malaria cases prior to treatment. Poor usage of malaria test results in health care delivery is one of the possible causes of over-diagnosis and over-treatment of malaria in Nigeria. This study demonstrated the influence of in-service training on malaria microscopy amongst medical laboratory scientists on the utilization of malaria microscopy results in a selected Government Health Facility in Nigeria. In 2014, a baseline study was conducted, and a follow-up study was conducted in which end users of laboratory results in selected secondary health facilities were given a pre-tested questionnaire on perception and utilization of malaria microscopy results by health care providers in malaria case management. Medical laboratory scientists working in these selected facilities were then given basic malaria microscopy training in accordance with the World Health Organization's (WHO) basic microscopy training manual. The training was followed by a supporting supervision visit to the Medical Laboratories, where other factors that can skew microscopy results, such as the need for special equipment, were addressed during the basic and refresher training. We conducted paired t-test to determine statistically significant differences between pre-test and post-test results at 0.05 significance level and ANOVA to determine if there were differences in knowledge level before and after the training and between the basic and refresher training. The study demonstrates a significant improvement in both the basic and refresher training mean parasite detection pre-and post-tests scores from 56.3% (95% CI 53.6-58.8%) to 77.7% (95% CI 74.4-80.2%) and 76.7 (95% CI 74.2-79.2%) to 91.2% (95% CI 88.3-94.1%)(P< 0.001). When comparing the rate of utilization of malaria results from trained Medical Laboratory Scientists to the baseline and follow-up studies, as well as the assessment of facilities' malaria test requests and utilization pattern during the study period, there was a substantial difference (p< 0.001). The increase in utilization of malaria microscopy result for effective case management of malaria in the study area was influenced by training outcome and competency of Medical Laboratory Scientists. Key words: Malaria results, microscopy T raining, medical Laboratory scientists, health care providers.